Areas of Surgery

Liposuction

Q: What is Liposuction?

This is a cosmetic surgery procedures designed to remove unwanted fat from different areas on the body. The fat is suctioned out through a hollow tube with the help of a vacuum machine. This procedure is particularly effective for areas where the fat cannot be removed by diet control or exercise; it is also very effective for the chin face & neck.

Q: What are the body areas where liposuction can help?

Abdomen front (tummy/paunch)
Flanks (love handles)
Either or both of the above will improve the waistline
Buttocks
Hips
Thighs-inner and outer
Chest (female breast or male Gynaecomastia)
Arms
Cheek, Chin, Neck.

Unwanted fat in waist, hips, buttock & inner thighs-corrected by liposuction alone
Excess inner thigh fat results in skin irritation due to the thighs rubbing each other.

Big (Fat) buttocks reduced to reasonable (proportionate) size by liposuction.

Correction of upper back thick skin fold by liposuction

Improved shape of the inner arm after correction by liposuction

Q: What are the problems due to unwanted fat?

Functional problems are due to excess total body fat. Excess body fat is an invitation to a host of problems; heat disease, high blood pressure, elevated cholesterol, diabetes and joint problems to name just a few. Reduction of body fat to optimum levels by diet control, exercise can help to reverse these problems as well.

Functional problems can result from excess local fat at times.

Excess inner thigh fat results in painful skin irritation due to rubbing of the thighs against each other.
Excess lower abdomen fat when severe can cause problem in hygiene in the groin or trouble during intimate moments in personal life.

Psychological problems result from unwanted local fat.

Fat in some areas unfortunately is not under the control of diet (intake) or exercise. This fat results in an awkward appearance, self-consciousness and related problems. People are restricted on many issues in daily life such as choice of clothes, hesitation in sports activities. People can be subjected to taunts, teasing leading to loss of self-confidence and self-esteem. Postural and clothing modifications to mask the problem are commonly done to prevent the shame and humiliation that can occur if it is seen.

Q: Who is a suitable candidate for this procedure?

Usually people with normal or near normal body weight, but with mild to moderate excess fat in limited areas of the body are most suitable to benefit from this procedure. In spite of keeping good health by diet control and exercise, this local fat excess ‘refuses to go’- for example in the tummy in males and hips, buttocks, or thighs in females. Frustrated with the unsuccessful efforts, most people usually give up the exercise and diet control and regain the lost weight.

This excess fat is genetically programmed not to respond to general measures like exercise and diet control which fat in other areas respond to. Removal of this stubborn fat by a surgical procedure 'in one go' restores the 'missing link' in an otherwise smart body. This gives the person enough motivation to continue with exercise and healthy diet and maintain a good health.

Tummy shape improved by liposuction alone in a young person with good skin elasticity

Compare the above picture to the person below with loose tummy; here the laxity is less than the person above but the person is older here. Hence loose skin needed to to cut and removed by tummy tuck surgery. Liposuction alone would not have helped.

Sometimes, when multiple areas are involved, all unwanted fat cannot be removed in a single procedure; the different areas are treated in two procedures with a few weeks gap in between.

Q: Is it necessary to have skin removed or tucked after liposuction?

As described above, in younger people with elastic skin, the skin shrinks to the new body shape after fat removal.

If the skin is hanging really loose even before the fat removal, chances are that the skin will have to be tucked (removed) at the same time as the liposuction to achieve a pleasant appearance-usually seen in the arm or front of tummy. This skin removal will be needed even with mild skin looseness if the person is slightly older when the skin elasticity is not adequate for natural shrinkage.

In some borderline situations, the skin removal can be done at a later date as a second procedure, only if the skin fails to shrink adequately over few months.

Q: Can the fat reappear after liposuction, either at the same or another place?

Each of us is born with a fixed number of fat cells, so when liposuction is performed the net cell number in the given area decreases permanently. So weight gain in this area is less likely than other parts of the body due to a lesser cell number. Further, if total body weight does not increase, fat in the other areas also will stay the same. However, if a person follows an unhealthy diet or lifestyle, total body weight will increase, and so will the fat in the areas where liposuction was done.

Q: What evaluation is done in the initial consultation?

The areas for liposuction are decided depending on both the person's wishes and the surgeon's evaluation.
A complete medical history and general examination for problems such as diabetes, high blood pressure and heart problems is also done.
Your present body weight and plans for loosing weight in the future are evaluated.
Your skin texture and elasticity are assessed.
Photographs of the area are taken as part of medical records.
Measurements for a Pressure Garment are taken, this has to be worn post-op for about 6weeks post-op. it can be worn inside regular clothes and it washable.

Q: What are the possible risks/complications with Liposuction?

Though uncommon in most people, you will be informed in case of any special risk in your case to any of the problems.

Wound infection requiring antibiotics
Excess bleeding
Excess skin bruising
Temporary numbness (loss of sensation) to the skin.
Surgical scars may become red, raised and thick-can take upto 18 months to heal.

Other details about the procedure.
The tumescent technique is used most commonly worldwide. Once the anaesthetic agent has acted, large volumes of fluids are injected into the area needing fat removal. The fat becomes loose and is then removed by a larger hollow tube (cannula) with the help of a suction machine.
The procedure is done under general or regional anaesthesia; an overnight stay in the hospital is hence recommended.

Q: How painful is the procedure?

Pain at time of surgery is nil, as anaesthesia is used. After the surgery, a pre decided combination of intravenous & oral medications ensure that pain is never a problem. Once the patient feels confident with the existing soreness & stiffness after surgery (usually in a day or so), is able to move around indoors, patient is send home with medications.

Q: What preparation is required before I go in for the procedure?

Smoking has to be stopped about 4 weeks prior to the procedure.
Blood thinning drugs (Aspirin/Dispirin) and Vitamins need to be stopped 2 weeks prior.
Fasting is needed at least 6 hours prior to the procedure.
You need to be accompanied by a responsible adult throughout your stay in the hospital.

Q: What can I expect immediately after the operation?

You will be wearing the tight fitting pressure garment at end of surgery.
Some oozing of blood tinged fluid may be seen for 24 hours after the procedure; the dressings will be changed at 48-72 hours-a shower can be taken after this.
Any obvious swelling and bruising will subside over 24 hours.
Pain is usually minimal and easily controlled by pain killers.
About 2 weeks of rest at home is usually required after the surgery.

Q: How is the Recovery after the procedure?

Back to work:1-2 weeks, depending on the extent of surgery
Strenuous activity: 2-3 weeks
Swelling & bruising: (if any) 3-6months

Q: What should the long term outlook be after the procedure?

A successful liposuction restores a pleasant appearance, makes a significant improvement to the person's self confidence. By removing fat that does not reduce with diet control and exercise, the motivation to stay fit and healthy by strict diet & exercise stays for a long time.